WSC 2022 | Current recommendations for blood pressure control in ischemic and hemorrhagic stroke

Adnan Qureshi, MD, University of Missouri-Columbia, Columbia, MO, shares an overview of the latest guidelines for blood pressure (BP) management in patients with acute ischemic stroke (AIS) or intracerebral hemorrhage (ICH). In the AIS setting, standard practice for BP lowering has remained the same for some time: maintaining systolic BP below 180mmHg after successful endovascular therapy. To expand on this, the BP-TARGET trial (NCT03160677) tested the safety and efficacy of more intensive BP lowering to a target of 100–129 mm Hg, compared to standard BP lowering (130–185 mm Hg). More intensive lowering did not provide any benefit over standard lowering for intraparenchymal hemorrhage rates or mortality. For ICH, the ATACH-2 (NCT01176565) and INTERACT2 (NCT00716079) both assessed intensive BP lowering (110-139 mmHg) versus standard BP lowering (140-179 mm Hg), showing that more intensive BP lowering did not achieve lower rates of death or disability compared to standard reduction. Additionally, the rates of renal adverse events were significantly higher in the intensive treatment group compared to the standard group. This interview took place at the World Stroke Congress 2022 in Singapore.

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